CDK12 as a Potential Biomarker for Characterization of Circulating Tumor Cells in Epithelial Ovarian Tumors

Introduction: The utility of epithelial markers is limited for the detection of circulatory tumor cells in patients with epithelial ovarian tumors, as these markers do not relate to clinicopathological characteristics nor assist in decision making for chemotherapeutic strategies. Cyclin-dependent kinase 12 (CDK12) has been implicated in the pathogenesis of ovarian cancer and holds potential as a valuable biomarker for diagnosis, prognosis, and the development of personalized therapeutic approaches. Aim: The study is aimed at assessing EPCAM+CDK12+ circulating tumor cells (CTCs) of patients diagnosed with epithelial ovarian tumors. Method: A total of 46 cases were included in the study, with 35 cases of epithelial ovarian neoplasms diagnosed as benign, borderline, and malignant tumors, and 11 cases in the control group. The percentage of EPCAM+CDK12+ CTCs in negatively selected CD45 (leukocyte common antigen) cells in all cases was assessed by flow cytometry. Result: Data analysis was performed by SPSS version 27.0. We found a significant difference in EPCAM+CDK12+ CTCs count between benign and malignant tumors (p < 0.03) and control and malignant (p < 0.004). A cut-off value of 0.35 percent cell count was calculated to differentiate benign from malignant ovarian tumors. Flow cytometry detected CTCs with a sensitivity of 68.4% and specificity of 83.3% respectively, with an area under the curve of 0.820 (P < 0.003). Conclusion: Hence, the study demonstrated the potential of CDK12 as a biomarker for future blood-based diagnosis and personalized treatment in epithelial ovarian tumor patients.